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Now being served, better nutrition advice

Our Healthy Eating Plate alternative to the government’s MyPlate.

Several months after the U.S. Department of Agriculture released the latest version of its Dietary Guidelines, the department unveiled the icon that’s supposed to convey the main points. Dietary guidelines go back to the 1910s, and wheels, boxed groupings, and pyramids have been used to illustrate the prior versions. The government was smart to pick a plate this time. Pyramid imagery can show priorities and proportions, but no one — not even the ancient Egyptians — has ever eaten off a pyramid. The MyPlate icon is also easy to remember with just four categories: fruits, vegetables, grains, and protein. In that way, it harkens back to the four basic food groups — meat; milk; vegetables and fruit; bread and cereal — that many of us grew up with.

But in a well-intentioned effort to perhaps keep the message simple, the MyPlate icon doesn’t say enough about the food choices that people should make — although, in fairness, the bulleted text that goes along with the brightly colored plate does provide some useful guidance.

The MyPlate icon also reflects some dubious aspects of the 2010 Dietary Guidelines (they are dated 2010 but were released in 2011). Dairy is featured prominently, suggesting that a glass of milk should be part of every meal. Some dairy in the diet is okay, but large amounts are, at the very least, unnecessary, and they may even be harmful, increasing the risk for certain cancers.

A plate of our own

So here at Harvard Health Publications, the consumer health publishing group at Harvard Medical School and the publisher of the Health Letter, we decided to cook up an alternative. In collaboration with the nutrition department at the Harvard School of Public Health, we created the Healthy Eating Plate (see illustration; you can also download a PDF at Dr. Walter C. Willett, chair of the school’s nutrition department and a member of the Health Letter‘s editorial board, was especially instrumental in shaping the content.

illustration of Harvard Healthy Eating Plate

In certain respects, our plate just adds some substance to the government’s rather sparse version. Like the government version, it’s divided into sections that are meant to suggest relative proportions of different types of food, not strict calorie counts. In other respects, the Healthy Eating Plate is supposed to correct some misconceptions about good nutrition, such as the overemphasis on dairy and a reluctance to acknowledge healthful fats, which the 2010 Dietary Guidelines and the MyPlate icon perpetuate.

Following are some of the highlights of the Healthy Eating Plate and how it differs from the government’s MyPlate.

More vegetables than fruit

Both plates indicate that we should eat more vegetables than fruit. Some commonly consumed fruits have a fair number of calories because of their starch or sugar content, so it’s possible to overdo your fruit intake. Most vegetables have very few calories, so we can eat more of them and not worry about the calories piling up.

Potatoes don’t count

In subsistence situations, potatoes are a great food, an all-in-one package of needed calories, protein (as much as some grains), vitamins (it’s important to cook them with the skin on to retain the vitamin C), and minerals (potassium and others). But in this and other countries with a relative abundance of food, the drawbacks of the starch content overshadow the potato’s nutritional virtues. The starch is digested quickly, so it causes the same sort of harmful spikes in blood sugar as refined grains (white bread) and sugary foods (soda). So letting potatoes count as vegetables and fill up that portion of the plate is a bad idea — yet that’s what the government’s current nutrition guidance allows. The Healthy Eating Plate states explicitly that potatoes and French fries should not count as vegetables.

Healthful fats belong

For two decades, the government’s nutrition advice has relegated fat to the dietary sidelines. The first food pyramid, which was released in 1992, said “fats, oils, and sweets: use sparingly.” The 2010 guidelines aren’t as negative, but they do advise limiting fat intake (for adults, the ceiling is between 20% and 35% of daily calorie intake). And fat doesn’t appear anywhere on the MyPlate icon.

Coaching people to eat less fat led to greater consumption of refined carbohydrates (sugar and refined grains), which lowers “good” HDL cholesterol and increases triglycerides, changes that increase heart attack risk. Research has shown that the total amount of fat in people’s diets has little bearing on the risk of heart disease, diabetes, or breast cancer. The type of fat is more important. Artificially produced trans fat is the worst. Research has cast saturated fat (the kind found in meat and dairy products) in a more favorable light. Still, studies show that replacing saturated fat with polyunsaturated fat (the kind found in liquid vegetable oils) lowers your heart disease risk.

So the Healthy Eating Plate encourages people to consume fat in the form of healthful oils (olive and canola oils are mentioned by name, but sunflower, safflower, corn, and other plant-based oils also fill the bill). A cruet of oil sits right next to the plate, and the accompanying text urges people to use healthful oils in cooking, salad dressing, and the like. Butter, a source of saturated fat, is not banned, but our advice is to limit it. Trans fat, however, is banned.

Dairy wary

Another big difference between our plate and the government’s is the role of dairy in the diet. The government’s MyPlate suggests that it should be a regular part of the diet and consumed at every meal. Our Healthy Eating Plate swaps out dairy for a glass of water. Tea or coffee, with little or no sugar added, are mentioned as alternatives to water (although obviously not for young children). Sugary drinks, like soda, don’t belong anywhere near a healthful diet.

One or two servings a day of low-fat dairy is not a problem. But beyond that amount, the additional calcium from dairy provides little if any benefit to bones. Diets high in calcium — from any source, not just dairy products — have been linked to prostate cancer. There is also a possible connection between lactose, the sugar in dairy products, and ovarian cancer.

Healthful protein

Besides encouraging people to eat seafood and lean cuts of meat, the 2010 Dietary Guidelines don’t provide much direction when it comes to healthful sources of protein. And the MyPlate icon? It simply says protein, with no additional information.

That’s a shame, because it’s pretty clear that people should be advised to eat red meat (beef, lamb, pork) in limited amounts. The heme iron in red meat has been associated with heart attacks and fatal heart disease in many studies. Moreover, studies have linked red meat intake, especially processed meat, to some cancers, such as colon cancer.

Our Healthy Eating Plate encourages people to get their protein from fish, poultry, beans, or nuts; rarely eat red meat; and avoid processed meat like bacon and sausage. Using data from the Nurses’ Health Study, Harvard researchers calculated in 2010 that if people were to replace red meat with nuts, low-fat dairy, poultry, or fish (the best option), they would substantially reduce their heart disease risk.

National Cancer Institute researchers performed some similar calculations using data from a different study. They concluded that a relatively small increase in fish and poultry consumption when matched by a similar decrease in red meat consumption reduces the risk for several types of cancer, including colon, lung, and liver cancer.

Posted by: Dr.Health

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